Flashcards in First Aid: Substance Related Disorders Deck (158)
What is the DSM-IV criteria for substance abuse?
Pattern of substance use leading to impairment or distress for at least 1 year with 1 or more of the following manifestations:
-Failure to fulfill obligations at work, school or home
-Use in dangerous situations (ex. driving a car)
-Recurrent substance-related legal problems
-Continued use despite social or interpersonal problems due to the substance use
What is the DSM-IV criteria for substance dependence?
Dependence is substance use leading to impairment or distress manifested by at least 3 of the following within a 12-month period:
-Using substance more than originally intended
-Persistent desire or unsuccessful efforts to cut down on use
-Significant time spent in getting, using or recovering from substance
-Decreased social, occupational, or recreational activities because of substance use
-Continued use despite subsequent physical or psychological problem
What diagnosis supercedes substance abuse?
What is the lifetime prevalence of substance abuse or dependence in the US?
What is the gender difference in substance use and dependence?
men > women
What are the most commonly used substances?
What mood symptoms are common among those with substance abuse or dependence?
The development of a substance-specific syndrome due to the cessation of substance use that has been heavy and prolonged.
The need for increased amounts of the substance to achieve the desired effect or diminished effect if using the same amount of the substance.
What does ETOH do in the brain?
-Activates GABA (inhibitory) and serotonin receptors
-Inhibits glutamate receptors
What percentage of Americans are alcoholics?
List the first two steps in alcohol metabolism.
Alcohol dehydrogenase converts alcohol to acetaldehyde. Aldehyde dehydrogenase converts acetaldehyde to acetic acid.
True or false: alcohol is the most commonly abused substance in the USA?
What should be used to screen for alcohol abuse?
What is considered a positive CAGE?
two or more "yes" answer
At what BAL do most adults (>50%) show obvious signs of intoxication?
What is the legal limit for intoxication in most states?
.08 - .10 mg%
At what BAL do you see decreased fine motor control
.02 - .05 mg%
At what BAL do you see impaired judgement and coordination?
.05 - .1 mg%
At what BAL do you see ataxic gait and poor balance?
.1 - .15 mg%
At what BAL do you see lethargy and difficulty sitting upright?
.15 - .25 mg%
At what BAL do you see coma in the NOVICE drinker?
At what BAL do you see respiratory depression?
What medical phenomenon can methanol, ethanol and ethylene glycol all cause?
increased anion gap metabolic acidosis
What medications should be given to patients who present with altered mental status?
What is the treatment for acute ETOH intoxication?
-Ensure adequate airway, breathing and circulation
-Monitor electrolytes and acid-base status
-Obtain finger-stick glucose level to exclude hypoglycemia
-Thiamine, naloxone and folate
Why do you give thiamine to an intoxicated person?
to prevent or treat Wernicke's encephalopathy
Why do you give naloxone to an intoxicated person?
to reverse the effects of any opioids that may have been ingested
When would you use gastric lavage or charcoal in the treatment of ETOH overdose?
only if it is mixed ETOH-drug overdose